Introduction
Dietary recommendations in heart failure management are contradictory to findings established by the obesity paradox. The objective of this study was to investigate if a weight reduction could reduce symptoms of heart failure; thus resulting in an improvement of body composition, plasma lipid profile, and functional status and thereby positively affect cardiac function.
Methods
We enrolled 26 obese patients with heart failure and NYHA II or III. They were randomly assigned to adhere to a low-calorie diet (Nupo VLCD: 700 kcal/day + 100 kcal of supplementary food) or a conventional diet for 12 weeks. In the study, we assessed body weight and -composition, plasma lipid profile, NT-proBNP, functional status, and quality of life.
Results
Of the 26 patients, 18 completed the study (11 in the intervention group and 7 in the control group). The mean weight loss with the low-calorie diet (LCD) was 11.3% of initial body weight and the difference in mean weight loss between the low-calorie diet group and conventional diet group was 11.7 kg at the end of the study (95% CI: 6.8, 16.6, p<0.0001). Patients following the low-calorie diet significantly reduced their body mass index (p<0.0001, 95% CI: 2.3, 5.3), waist circumference (p<0.0001, 95% CI: 5.9, 15.3), and hip circumference (p<0.0010, 95% CI: 5, 15.2,) compared to the patients following the conventional diet. The walking distance significantly improved between baseline and week 12, the between-group difference amounted to 172m after 12 weeks p<0.0005. There was a significant mean difference for cholesterol- (p<0.0006), triglyceride-(p<0.0100), and low-density lipoprotein (p=0.0265) concentrations between baseline and week 8. Mean differences in plasma lipid levels were not significant at week 12.
Conclusion
In this small pilot study, a low-calorie diet led to a significant improvement in body weight and -composition and functional status in patients with heart failure. Larger studies need to confirm these preliminary findings.
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